Psychosocial impact of human papillomavirus on women's sexual dissatisfaction and quality of life

Purpose: This study assessed how psychological, socio-demographic and clinical variables were associated and moderated the relationship between sexual dissatisfaction and the psychosocial impact of the human papillomavirus (HPV) on the quality of life (QOL) of infected women. Methods: A cross-sectional design was used with a sample of 194 women. Participants completed a sociodemographic and clinical questionnaire, and were assessed on the psychosocial impact of HPV on quality of life (HPV Impact Profile), sexual dissatisfaction (Index of Sexual Satisfaction), psychological morbidity (Hospital Anxiety and Depression Scale), emotional suppression (Courtauld Emotional Control Scale) and spirituality (Spiritual and Religious Attitudes in Dealing with Illness). Results: Women with greater psychological morbidity and emotional suppression showed greater psychosocial impact of HPV on QOL. Greater psychological morbidity and emotional suppression, being older, having less education and not using condoms were associated with greater sexual dissatisfaction. Sexual dissatisfaction, psychological morbidity and age were associated with the impact of HPV on QOL. The variables that contributed to sexual dissatisfaction were age, emotional suppression and condom use. The use of condoms moderated the relationship between emotional suppression and sexual dissatisfaction. Conclusion: Interventions should focus on psychological morbidity and condom use, particularly in older and less educated women

Primary Biliary Cirrhosis with a normal Alkaline Phosphatase: a case report

A 78 year-old lady presented with abdominal swelling and fatigue. She was anaemic with mild hypoalbuminaemia, and had a normal alkaline phosphatase. Computed tomography showed hepatosplenomegaly and mild ascites. Anti mitochondrial antibodies were strongly positive, as were anti nuclear antibodies, and the gamma glutamyl-transferase was shown to be elevated. A diagnosis of primary biliary cirrhosis was made. A brief discussion of treatment of primary biliary cirrhosis follows. The case is notable for the fact that primary biliary cirrhosis can manifest clinically without an elevation in alkaline phosphatase – normally the hallmark of the disease

Levels of expression and immunogenicity of attenuated Salmonella enterica serovar typhimurium strains expressing Escherichia coli mutant heat-labile enterotoxin

The effects of heterologous gene dosage as well as Salmonella typhimurium strain variability on immune response toward both the heterologous antigen, the nontoxic mutant of the Escherichia coli heat-labile enterotoxin LTK63, and the carrier Salmonella strain have been analyzed, Effects of a single integration into the host DNA and different-copy-number episomal vectors were compared in S. typhimurium Delta cya Delta crp Delta asd strains of two different serotypes, UK-1 and SR-11, Expression of the enterotoxin in the different Salmonella isolates in vitro was found to vary considerably and, for the episomal vectors, to correlate with the plasmid copy number, LTK63-specific serum immunoglobulin G (IgG) and mucosal immunoglobulin A (IgA) antibodies were highest in mice immunized with the high-level-expression strain. High anti-LTK63 IgG and IgA titers were found to correspond to higher anti-Salmonella immunity, suggesting that LTK63 exerts an adjuvant effect on response to the carrier. Statistically significant differences in anti-LTK63 immune response were observed between groups of mice immunized with the attenuated Delta cya Delta crp UK-I and SR-II derivatives producing the antigen at the same rate, These data indicate that the same attenuation in S, typhimurium strains of different genetic backgrounds can influence significantly the immune response toward the heterologous antigen. Moreover, delivery of the LTK63 enterotoxin to the immune system by attenuated S. typhimurium strains is effective only when synthesis of the antigen is very high during the initial phase of invasion, while persistence of the S. typhimurium strain in deep tissues has only marginal influence.66122423

“When the felid’s away, the mesocarnivores play”: seasonal temporal segregation in a neotropical carnivore guild

Interspecific competition within a carnivore guild can result in segregation along dietary, spatial, and temporal scales. Species interactions and resulting avoidance behavior can change seasonally as landscape features and resource abundance may fluctuate. In this study, we examined a carnivore guild in the Pantanal wetland of Brazil to determine whether temporal niche partitioning was a mechanism for coexistence, and if this differed between the wet and dry season. We used camera trapping data to fit kernel density functions of time observations for five species of carnivores to determine activity patterns. We calculated the coefficient of overlap between all species-pair’s activity patterns. Our results found support for temporal segregation among this carnivore guild, with stronger segregation evident during the dry season. Jaguars and pumas showed large overlap in activity in both seasons, while all three mesocarnivores (ocelot, tayra, and crab-eating fox) showed temporal avoidance toward pumas. Mesocarnivores displayed segregating temporal patterns between pairs in both seasons. Temporal segregation is a mechanism for coexistence within this carnivore guild, suggesting increased competition between species especially during the dry season. To maintain carnivore populations, a broader knowledge of interspecific interactions and how this may affect species, utilization or avoidance of habitats is needed. Given the complexities of interspecific interactions among carnivores, conservation efforts should address the needs of the entire guild rather than focus on a single species

Family network of children with special health needs: implications for Nursing

OBJECTIVE: to describe appropriate sources and resources for caregivers of children with special health needs in the community. METHOD: A qualitative study that used the creativity and sensitivity dynamics speaking map, part of the sensitive creative method, involving 11 caregivers of children with special health needs who are assisted in a university hospital located in the South of Brazil. RESULTS: the maps graphically represented through the genogram and ecomap showed that the caregiving women consistently and regularly use the resources of the internal and external family network; they eventually and irregularly access the community social network for physical and psychological support. CONCLUSION: the reclusive nature of care for these children inside the family circle contributes to their social invisibility. Based on this new information, it is recommended that Nursing participate in the care that is focused on these children's families, with particular attention to their socio-cultural conditions

Characterization and genetic diversity in Paspalum notatum Flügge accessions: Morphological and geographical distance

The objective of this work was to describe morphology and grouping of Paspalum notatum accessions, based on multicategorical data which discards the redundant variables for quantification of genetic diversity. We also tested the hypothesis that geographical distance was correlated with morphological divergence. In our study, multivariate analyzes successfully demonstrated the geographic and morphological variability of the P. notatum accessions characterized. Many of these evaluated accessions can be included in future genetic improvement programs. Based on two methodologies for discarding variables, it was possible to identify the potentially important morphological characteristics from genetic diversity studies and characterize new accessions aimed at improving forage and seed production. The methodologies used to discard variables are biometric tools that can be used successfully in future plant breeding programs, especially when a large number of traits and accessions are being evaluated. Although significant, geographic distance had a low association with morphological traits. This indicated the need to use other characteristics, such as forage and seed yield, in addition to molecular analysis. Our analyzes showed genetic variability in P. notatum for all the characteristics studied

International Standards for Symphysis-Fundal Height Based on Serial Measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: Prospective Cohort Study in Eight Countries

Fetal growth assessment is important to identify fetuses with abnormal fetal growth that are at increased risk of perinatal morbidity and mortality. Serial measurement of symphysis-fundal height (SFH) is the recommended, inexpensive, and first-level screening tool in both low- and high-risk pregnancies. However, SFH measurements show a wide range of sensitivities for detecting small for gestational age (SGA) owing to the different measurement methods, charts, and thresholds used to perform an ultrasound scan and the use of uncorroborated menstrual dates that can cause errors in dating and can lead to overestimating the length of gestation. A prospective longitudinal observational study, the Fetal Growth Longitudinal Study, one of the main components of the INTERGROWTH-21st Project, was conducted on healthy, well-nourished women to develop international SFH standards to improve antenatal care. Of the 13,108 women screened in the first trimester, 4607 met study criteria, and of these, 4321 (93.8%) delivered live singletons without congenital malformations or complications. The median number of SFH measurements in all women was 5.0 (range, 1–7); 3976 (92.0%) women had 4 or more measurements. Analysis of the duplicate SFH measurements obtained from all women showed that the 95% limits of agreement were approximately 1.5 cm. The international standards developed through this study overcome many of the methodological limitations of SFH measurement by reducing the wide range in sensitivity for the detection of SGA and should reduce the risk of failing to diagnose restricted and excessive fetal growth and help in comparisons across populations. The new international SFH standards in combination with standardized measurement methodology are recommended to improve clinical practice

Avaliação de desempenho: discutindo a tecnologia para o planejamento e gestão de recursos humanos em saúde

Este ensaio apresenta o produto de reflexões e análises a partir do exame de opções conceituais inerentes às metodologias de avaliação de desempenho (AD) de profissionais e sua possibilidade de aplicação na área da saúde. Estabelece uma discussão conceitual para a área, articulando e integrando conhecimentos de campos distintos - o da saúde e o da administração pública. Promove a intersecção entre a gestão do trabalho em saúde no setor público e as técnicas da administração de pessoal. Pretende gerar novas análises e estudos que possibilitem uma releitura das práticas administrativas para avaliação de desempenho utilizadas nas organizações, adaptá-las para atender às especificidades do setor saúde